India: gender and health

GDP1 Current health expenditure2 Catastrophic health expenditure3 Proportion of out-of-pocket expenditure 4
6185.99 6650.11 7034.21 220.7 233.0 253.0 15.49 13.31 17.33 67.0 64.7 63.2 62.4
Unit:
Unit: PPP per capita
2017 2018 2019 $ INT 2015 2016 2017 current $ INT 2004 2009 2011 Unit: % 2014 2015 2016 2017 Unit: %

Why does gender matter for health in India? Poverty level5 GINI6 Sex ratio at birth7
34.4 35.4 35.7 110 males per
Gender is a major determinant of health for women and Unit:
100 females
22.5%
men in India. Gender norms, roles and relations interact Unit: scale of 0-100,
2011 % 2004 2009 2011 with 0 being better
with biological factors, in turn influencing people’s
exposure to disease and risks for ill health. Therefore, it HDI-IHDI8 GDI9 GII10
is important for health policy-makers to consider the
0.56 0.68 0.46 0.57 0.69 0.47 0.57 0.69 0.54 HDI female 0.827 0.829 0.829 0.538 0.522 0.501
different gender needs of all men and women. Tailoring HDI male
Unit:
health policies and programmes to take account of these IHDI
Unit: index
differences and trends can improve their impact, reduce Unit: index index from
health inequities and advance the right to health for all. from 0 to 1 from 0 to 1 0 to 1
2016 2017 2018 2016 2017 2018 2016 2017 2018

Do men and women in India have equal access to determinants of health?

Health is significantly determined by social, economic, and environmental factors that lie beyond the health sector, such as poverty, education, employment and physical security.
Gender inequality, an important determinant of health, remains a challenge in India, as elsewhere. Women lag behind men in many indicators of social well-being, such as access
to mass media and literacy. Women’s lower labour force participation and significantly larger time spent in unpaid care work also reflect gender inequality.

Only about six in 10 married women in India say that they, alone or jointly, make major Only about one in eight agricultural holders in India is a woman.12
household decisions.11

For every eight men, only seven women in India have regular access to at least one form Less than half as many women as men use Slightly over half as many women as
of mass media.13 the internet.14 men own mobile phones in India.15

NEWS

Literacy rate by sex16 Girls have achieved parity with boys in Girls comprise only about two in every five Women’s labour force participation is about 3.5
school enrolment.17 science, technology, engineering & times lower than that for men and this gap has
65.79 82.37 Female
mathematics graduates.18 persisted over time.19
Male 1.12 1.16 1.15 Primary

Secondary 26.2 79.9 23.3 79.1 20.8 74.6 Female

1.02 1.02 1.02 Male
Tertiary

1 1.02 1.04 1.07

2018 Unit: % 2015 2016 2017 2018 Unit: ratio 2010 2012 2018 Unit: %

A large proportion of men and women are Proportion of children engaged in About three in four women own a bank Women in India are estimated to earn only
employed in the informal sector.20 child labour by sex21 account in India.22 about US$ 2 for every US$ 10 earned
by men.23
75.9 80.0 Female
Male 11.9% 11.6%
Men $ $ $ $ $ $ $ $ $ $

Women $ $

2018 Unit: % 2005 2020

Fewer than one in seven managers in India is Indian women spend nearly 10 About 2.3% of households in India are
a woman.24 times as much time in unpaid now located more than half an hour from
domestic services and over three a water source.26
times as much in unpaid
caregiving services as men.25
Do men and women in India have similar life expectancies?

Women have slightly better life expectancy at birth than men in India.

Life expectancy and healthy life expectancy at birth by sex27

Male 2015 59.1 68.1 Healthy life expectancy at birth

Life expectancy at birth
Female 2015 59.2 70.6

Male 2019 60.3 69.5

Female 2019 60.4 72.2 Unit: Years

Do gender, location of residence, education and income affect the health status of people in India?
The health status of all women and men in India, as elsewhere, is determined by the interaction between social (gender) and biological (sex) differences. The differences in health status
between men and women go beyond sexual and reproductive health. Besides gender, factors such as location of residence (urban/rural), education and income also affect health status.

Disease burdens are different between men and women.

Road injuries and cirrhosis of the liver figure among the 10 leading causes of death and Road injuries and cirrhosis of the liver figure in the 10 leading causes of DALYs lost
DALYs lost among men, but not among women. Diabetes mellitus and falls feature in the among men, but not among women. Diabetes mellitus and iron deficiency anaemia
10 leading causes of death among women, but not among men. feature in the 10 leading causes of DALYS lost among women, but not among men.
10 leading causes of death among men and women28 10 leading causes of DALYs lost among men and women29

Male 30.40 Ischaemic heart disease Male 22.75 Ischaemic heart disease
13.07 Chronic obstructive pulmonary disease 12.93 Preterm birth complications
11.30 Stroke 11.11 Road injury
8.31 Lower respiratory infections 10.06 Chronic obstructive pulmonary disease
8.08 Tuberculosis 8.49 Lower respiratory infections
7.54 Road injury 8.06 Stroke
6.00 Cirrhosis of the liver 8.03 Tuberculosis
Unit: 5.52 Diarrhoeal disease Unit: 6.97 Diarrhoeal diseases
Cause-specific 4.89 Preterm birth complications Disease-specific 6.41 Cirrhosis of the liver
death rates as % DALYs lost as % of
of 10 leading causes 4.89 Kidney diseases 10 leading diseases 5.18 Self-harm

Female 23.71 Ischaemic heart disease Female 15.22 Ischaemic heart disease
15.18 Chronic obstructive pulmonary disease 14.53 Preterm birth complications
13.37 Lower respiratory infections 12.95 Lower respiratory infections
13.04 Stroke 10.87 Diarrhoeal diseases
8.89 Diarrhoeal disease 10.81 Iron-deficiency anaemia
6.12 Diabetes mellitus 10.11 Chronic obstructive pulmonary disease
6.07 Tuberculosis 8.52 Stroke
Unit: 5.51 Preterm birth complications Unit: 5.86 Tuberculosis
Cause-specific Disease-specific
death rates as %
4.12 Kidney diseases DALYs lost as % of
5.65 Self-harm
of 10 leading causes 3.99 Falls 10 leading diseases 5.47 Diabetes mellitus

The survival and nutritional status of children under five years of age have improved steadily. However, children of mothers with lower education levels and children from lower-income or rural
households tend to fare worse.
Under-five mortality rate by sex30 Under-five mortality rate by location of residence31 Under-five mortality rate by caste32

74 70 79 50 51 48 Total 52 82 34 56 55.9 57.2 50.8 38.5 52.3 SC

Urban
Male ST
Female Rural OBC
Other
Don’t know

Unit: per thousand Unit: per thousand Unit: per thousand

2005-06 2015-16 live births 2005-06 2015-16 live births 2015 live births

Nutritional status of children by sex33 Compared to their urban counterparts, children from rural areas have a 64%
higher risk of dying, a 33% higher risk of stunting, a 31% higher risk of being
48.0 48.1 48.0 42.5 41.9 43.1 19.8 20.5 19.1 38.4 38.9 37.9 35.7 36.1 35.3 21.0 21.9 20.1 Total
underweight and a 7% higher risk of wasting.34
Male
39.6 50.7 32.7 45.6 16.9 20.7 31.0 41.2 29.1 38.3 20.0 21.4
Female Urban

Rural

Stunting Underweight Wasting Stunting Underweight Wasting Unit: % Stunting Underweight Wasting Stunting Underweight Wasting Unit: %
2005-06 2015-16 2005-06 2015-16
In this age group, compared to children of highly educated mothers, children of uneducated mothers have a 143% higher risk of stunting, a 146% higher risk of being underweight, and a 26%
higher risk of wasting.35
57.2 48.5 38.1 19.4 52.0 42.5 32.1 15.8 22.8 19.8 16.4 13.1 50.8 43.5 32.8 20.9 46.8 40.1 31.1 19.0 22.7 21.3 20.6 17.9 No education
Primary
Secondary
Higher

Unit: %
Stunting Underweight Wasting Stunting Underweight Wasting
2005-06 2015-16

Compared to children from the richest households, children from the poorest households have a 131% higher risk of stunting, a 141% higher risk of being underweight and a 35% higher
risk of wasting.36
59.9 54.3 48.9 40.8 25.3 56.6 49.2 41.4 33.6 19.7 25.0 22.0 18.8 16.6 12.7 51.4 43.5 36.5 29.2 22.2 48.6 40.4 33.2 27.4 20.1 24.2 21.7 20.2 19.3 17.9 Poorest

$ Second
$ $
$ $ $ $ $ Middle
$ $
$ $ $ $ $ $
$ $ $ $ Fourth
$ $ $ $
$ $ $ $ $ $
$ $ $ $ $ $ $
$ $ $ $ $ $ $ $ Richest
$ $ $ $ $ $ $ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $
$ $ $ $ $ $ $ $ $ $ $ $ $ $ $
$ $
Stunting Underweight $ Wasting $ $
Stunting Underweight$ Wasting $
Unit: %
2005-06 2015-16

Compared to other children, children from scheduled caste households have a 45% higher probability of dying, a 37% higher probability of stunting, a Mothers’ chances of dying during and after
35% higher risk of being underweight and an 11% higher risk of wasting. Compared to other children, children from the scheduled tribes have a 48% childbirth in India have reduced by almost
higher probability of dying, a 40% higher probability of stunting, a 57% higher risk of being underweight and a 44% higher risk of wasting.37 two-fifths since 2000.38
SC
42.8 43.8 38.7 31.2 38.8 39.1 45.3 35.5 28.8 35.2 21.2 27.4 20.5 19.0 19.9 370 286 210 158 145
ST
OBC
Other
Unit: per
Don’t know 100,000
2015 2000 2005 2010 2015 2017 live births
Stunting Underweight Wasting Unit: per thousand live births

Total fertility rate by location of residence39 Total fertility rate by level of education40 Total fertility rate by household income quintile41

2.7 2.1 3.0 2.2 1.8 2.4 Total 3.6 2.6 2.2 1.6 3.1 2.5 2.1 1.6 No education 3.9 3.2 2.6 2.2 1.8 3.2 2.5 2.1 1.8 1.5 Poorest
Primary Second
Urban $ Middle
Secondary
$ Fourth
Higher $ $
Rural $
$ $ $ Richest
$ $
$ $ $ $ $
$ $
$ $ $ $ $
$ $ $ $
$ $ $
$ $ $ $ $
$ $ $
Unit: average number $ $ $ $ $ $ Unit: average number
Unit: average number $ $ $
$ $ $
2005-06 2015-16 of births per woman 2005-06 2015-16 of births per woman $ 2005-06
$ $ $ 2015-16
$ of births per woman

Total fertility rate by caste45

SC
2.26
ST
2.48
OBC
2015 2.22 Other
1.93 Don’t know
2.81 Unit: average number of births per woman

Fertility rates have declined more rapidly among adolescent women, compared to adult women, although inequities by location of residence, education and income persist.41
Adolescent fertility rate by location of residence42 Adolescent fertility rate by level of education43 Adolescent fertility rate by household income quintile44
Total No education Poorest
90 57 105 51 35 59 163 112 60 8 114 92 47 10 134 122 98 72 33 72 65 56 41 19
Primary Second
Urban $
Secondary Middle
$ $
Rural Higher Fourth
$ $
$ $ Richest
$
$ $ $
$ $ $ $
$ $
$ $ $ $ $
$ $
$ $ $ $ $
$ $ $
$ $ $ $ $
$ $ $ $
$ $ $ $ $ $
$ $ $ $
Unit: per thousand Unit: per thousand $ $ $ $ $ Unit: per thousand
$ $ $
women aged 15-19 women aged 15-19 2005-06 2015-16 women aged 15-19
2005-06 2015-16 2005-06 2015-16
Do gender, location of residence, education and income affect the exposure to health risks and vulnerabilities in India?

Biological and gender-related factors interact to result in differences between men and women in India in their exposure to health risks and vulnerabilities. Besides gender,
location of residence (urban/rural), education and income also affect exposure to health risks and vulnerabilities.

Overweight prevalence among adults by sex46 Obesity prevalence among adults by sex47
18.1 16.3 19.9 Total 4.9 3.0 6.8 Total
The higher prevalence of overweight and obesity among Male Male
women than men and the lower prevalence of physical Female Female
activity among girls than boys represent higher exposure
to risk of noncommunicable diseases.

2004 Unit: % population 2004 Unit: % population

Alcohol consumption among adults by sex48 Prevalence rate of current tobacco smoking among adults by sex49 Prevalence rate of current tobacco
use among adolescents by sex50
31.9 2.2 29.2 1.2 Male 12.1 22.4 1.7 11.8 22.2 1.4 Total
Female Male 16.8 9.4 19.0 8.3 Male

Female
Female

Unit: %
2005-06 2015-16 Unit: % population 2016 2018 Unit: % population 2006 2009 population

Overweight among adolescents by sex51 Obesity among adolescents by sex52 Physical activity among adolescents by sex53

10.8 11.6 9.7 Total 2.1 2.5 1.5 Total 30.2 31.0 29.1 Total
Male Male Male
Female Female Female

2007 Unit: % population 2007 Unit: % population 2007 Unit: % population

Fewer than one in every five adolescent girls in India Women and girls are exposed to household smoke from fuels, while More than one in three women in India experience
has comprehensive knowledge about HIV/AIDS.54 performing their assigned gender role of cooking. In India, nearly intimate partner violence in their lifetime, with rural
three in every five households use unclean fuels for cooking.55 and uneducated women and those from the poorest
households facing significantly higher risk.56

The probability of experiencing such violence is 32% higher for rural women than urban women, 188% higher for uneducated women compared to women with the highest levels of education and 166%
higher for women from the poorest households than those from the richest households.57

28.7 23.5 31.2 Total 38.1 33.8 23.4 13.2 No education 42.4 34.8 29.3 24.1 15.9 Poorest
Primary Second
Urban $
Secondary
$ Middle
Higher
Rural $
$ Fourth
$
$ Richest
$ $
$
$ $
$
$ $
$ $
$ $
$ $
$ $
$ $ $
$ $
$ $ $
$ $
$ $ $
$ $
$ $ $
$ $
Unit: % $ $ $
Unit: % population $ $ Unit:%
$ $
2015-16 population 2015-16 2015-16 population
Do gender, location of residence, education and income affect access to health services in India?

Geographical, financial, socio-cultural or other barriers may compound gender-related barriers to access to services. Women in India report facing gender-related barriers such
as lack of access to household resources such as money, distance to health facility, issues of transport and lack of availability of a woman health provider.

DTP3 vaccination rate by sex58 DTP3 vaccination rate by location of residence59 Children of mothers with the highest levels of education have a 26%
higher rate of DTP vaccination than children of uneducated mothers.60
55.3 57.4 53.0 78.4 78.3 78.5 Total 69.1 50.4 80.2 77.7 Urban
Male 36.9 57.6 75.3 89.0 68.3 77.6 82.5 86.6
Female Rural
No education
Primary
Secondary
Higher

Unit: % Unit: % Unit: %

2005-06 2015-16 population 2005-06 2015-16 population
2005-06 2015-16 population

Children from the richest households have a 21% higher DTP vaccination rate than those from Women from urban areas have an 18% higher probability of receiving antenatal care.62
the poorest households.61
33.9 47.1 58.4 68.5 81.9 70.0 76.8 80.5 83.4 85.3 73.2 89.0 67.4 79.3 89.1 75.1 Total
Poorest
$ $ $ Urban
$
$ $ Second
$ $ $ $ $
$ $ Rural
$ $ $ $ $ $ Middle
$ $
$ $ $ $ $ $ $ Fourth
$ $
$ $ $ $ $ $ $
$ $ Richest
$ $ $ $
$ $ $ $ $
$ $
$ $ $ $ $ $ $
$ $
$ $ $ $ Unit: % women
$ $ $ $ $
2005-06 2015-16 Unit: % population 2005-06 2015-16

Women with the highest education levels have a 54% higher Women from urban areas have a 15% higher probability of Rural women have about 15% greater probability
probability of receiving antenatal care than those with receiving skilled birth attendance than rural women.64 than their urban counterparts of having an unmet
no education.63 for family planning than those from urban areas. need for family planning.65
Total
45.5 73.0 36.1 81.4 90.0 78.0
56.8 78.4 90.3 98.1 60.6 77.3 87.1 93.8 No education
Urban 10.4 7.7 11.7 9.4 8.6 9.9 Total
Primary
Urban
Rural
Secondary
Higher Rural

Unit: % Unit: % Unit: %

2005-06 2015-16 2005-06 2015-16 2005-06 2015-16

Unmet need for family planning by level of education66 Women from the poorest households have a 50% higher probability of having an unmet need for
family planning than women from the richest households.67
12.8 10.3 8.6 6.4 9.6 9.4 9.2 9.9 No education 15.3 12.4 10.2 8.6 6.8 12.6 9.6 8.4 8.6 8.4 Poorest
Primary Second
Secondary $ Middle
Higher $
$ $ Fourth
$
$ $ $ Richest
$ $
$ $ $ $ $ $ $
$ $
$ $ $ $ $ $ $ $
$ $
$ $ $ $ $ $ $ $
$ $
$ $ $ $ $ $ $ $
$ $
Unit: % $ $ $ $ $ $ $ $ Unit: %
$ $
2005-06 2015-16 2005-06 2015-16

Compared to men, a larger proportion of women with raised blood glucose go undiagnosed and a lower proportion of them receive treatment. Enrolment in health insurance by sex71
This diagnosis and treatment gap is also seen for hypertension.68
Diagnosis, treatment and control of blood sugar among adults by sex69 Diagnosis, treatment and control of blood pressure among adults by sex70 22.9 20.4

56.5 9.3 23.0 11.2 72.3 13.3 8.0 6.4

Total Total

51.8 8.4 26.6 13.2 77.4 11.7 5.4 5.5

Male Male

60.6 10.1 19.9 9.4 66.1 15.3 11.2 7.4

Female Female

Undiagnosed Treated but uncontrolled Unit: % Undiagnosed Treated but uncontrolled Unit: % Unit: %
Diagnosed but untreated Treated and controlled 2017 Diagnosed but untreated Treated and controlled 2017 Male Female 2015
Are gender, equity and human rights perspectives reflected in the legal and institutional arrangements and capacity in India?

Ratification of treaties that include the right to health72

Ratified International Covenant on Economic, Social, and Cultural Rights

Ratified International Covenant on Civil and Political Rights
Ratified International Convention on the Elimination of all forms of Racial Discrimination
Ratified Convention on the Elimination of All Forms of Discrimination against Women
Ratified Convention on the Rights of the Child
Nil International Convention on the Protection of the Rights of all Migrant Workers and Members of their Families
Ratified Convention on the Rights of Persons with Disabilities

Constitutional provisions on equality and non-discrimination73

• “The State shall not deny to any person equality before the law or the equal protection of the laws within the territory of India” (Article 14).
• “The State shall not discriminate against any citizen on grounds only of religion, race, caste, sex, place of birth or any of them” [Article 15(1)].

Legal arrangements related to inheritance, land ownership, divorce, marriage, sexual orientation, gender identity and intimate partner violence74

Inheritance Land ownership Divorce Intimate partner violence 75

Widows and daughters enjoy
0 the same rights as widowers
and sons to inherit land and
non-land assets. This applies
to all groups of women.
Customary, religious and
traditional laws or practices
do not discriminate against
women's inheritance rights.
Women and men have the same legal rights
0 and secure access to land assets, without
legal exceptions regarding some groups of
women. Customary, religious and traditional
laws or practices do not discriminate
against women’s legal rights.
Women have both the same rights to initiate
0 divorce and the same requirements to finalise
divorce or annulment as men, without
negative repercussions on their parental
authority. This applies to all groups of
women. Customary, religious and traditional
laws or practices do not discriminate against
women's rights regarding divorce or parental
authority after divorce.
The legal framework protects women
0 from violence including intimate
partner violence, rape and sexual
harassment, without any legal
exceptions and in a
comprehensive approach.

Widows and daughters enjoy
0.25 the same rights as widowers
and sons to inherit land and
non-land assets. This applies
to all groups of women.
However, there are some
customary, religious or
traditional laws that
discriminate against women's
inheritance rights.
Women and men have the same legal rights
0.25 and secure access to land assets, without
legal exceptions regarding some groups of
women. However, some customary,
religious or traditional practices or laws
discriminate against women’s legal rights.
Women have both the same rights to initiate
0.25 divorce and the same requirements to finalise
divorce or annulment as men, without
negative repercussions on their parental
authority. This applies to all groups of
women. However, there are some customary,
religious or traditional laws or practices that
discriminate against women's rights
regarding divorce and/or parental authority
after divorce.
The legal framework protects women
0.25 from violence including intimate
partner violence, rape and sexual
harassment, without any legal
exceptions. However, the approach is
not comprehensive.

Widows and daughters enjoy
0.5 the same rights as widowers
and sons to inherit land and
non-land assets. However,
this does not apply to all
groups of women.
Women and men have the same legal rights
0.5 and secure access to land assets. However,
this does not apply to all groups of women.
Women have both the same rights to initiate
0.5 divorce and the same requirements to finalise
divorce or annulment as men, without
negative repercussions on their parental
authority. However, this does not apply to all
groups of women.
The legal framework protects women
0.5 from violence including intimate
partner violence, rape and sexual
harassment. However, some legal
exceptions occur.

Widows or daughters do not
0.75 enjoy the same rights as
widowers and sons to inherit
land and/or non-land assets.
Women and men have the same legal rights
0.75 to own land assets; but not to use, make
decisions and/or use land assets
as collateral.
Women do not have the same rights over
0.75 divorce as men: either their rights to initiate
divorce and/or the requirements to finalise
divorce or annulment are unequal, or their
parental authority after divorce is restricted.
The legal framework protects women
0.75 from some forms of violence including
intimate partner violence, rape or
sexual harassment but not all.

Widows and daughters do not
1 enjoy the same rights as
widowers and sons to inherit
land and/or non-land assets.
Women do not have the same legal rights as
1 men to own land assets.
Women do not have the same rights over
1 divorce as men: their rights to initiate divorce
and/or the requirements to finalise divorce or
annulment are unequal, and their parental
authority after divorce is restricted.
The legal framework does not protect
1 women from violence nor intimate
partner violence nor rape and
sexual harassment.

Name of law: The Protection of

Women from Domestic Violence
India score Act of 2005

Marriage76
Child marriage is illegal according to the Prohibition of Child Marriage Act (2006).

Legal protection for all sexual orientations and gender identities.77

No criminalization of same sex sexual acts, per a 2018 Supreme Court verdict. However, same sex marriages have no legal validity in India. A 2014 Supreme Court judgment recognises the right of
transgender persons to “decide their self-identified gender” as male, female, or third-gender, and directs “Centre and State governments” to recognise them as such. A “third gender” option can be chosen
on Aadhar cards, ration cards and voter IDs, with no additional eligibility criteria. However, there is no provision to address discrimination against the LGBTQ community in employment, education
or healthcare.
Legal arrangements related to sexual and reproductive health and rights78

Abortion Direct support for family planning

Permitted when there is fetal impairment, intellectual or cognitive impairment of the mother, mental or physical health reasons, or if the life Yes, direct support is provided by the legal framework.
of the mother is at risk.

Institutional arrangements and capacity79

National gender machinery National Commission for Women, Parliamentary Committee on the Empowerment of Women & Ministry of Women and Child Development.
Whether national development policy mentions gender Strategy for New India @75 (Niti Aayog), 2018.
mainstreaming and the most recent one?
Gender policy from national women's machinery Yes. Draft National Policy for Women, 2016.
and year introduced?
Gender-responsive budgeting80

Mention of gender-responsive budgeting in plans, year introduced Yes, 2002

Legislation for gender-responsive budgeting No

National plan/strategy for gender-responsive budgeting
Yes. Since 2005-06, the Expenditure Division of the Ministry of Finance issues a note on gender budgeting as
part of the Budget Circular every year. A Charter for Gender Budget Cells, issued on 8 March 2007 by the
Department of Expenditure, Ministry of Finance, laid out the composition and functions of these cells and
introduced a scheme to build capacity on gender budgeting and encourage research, to promote a gender
perspective at all levels of the planning, budget formulation and implementation processes.

Gender focal points in government81 Yes. Gender focal points, gender desks, and gender budgeting cells are set up in Ministries, state government departments, panchayats, and urban
local bodies.
Gender policy/strategy in the Ministry of Health82 None specifically.

Gender training for Ministry of Health staff83 Yes. Usually, an annual five-day training on gender mainstreaming in health for health professionals is organized by the National Institute of Health
and Family Welfare, New Delhi.

Conclusion

Forward-looking policies, if effectively implemented through suitable institutional mechanisms and adequate capacity support the mainstreaming of gender, equity and
human rights perspectives in health and enable change towards greater equity.
Recommendations
• Given the influence of gender on health in India, putting a gender perspective into health interventions is important. When applying a gender lens to health interventions, it is
important to remember that gender interacts with other forms of social exclusion, such as ethnicity, age, sexual orientation and socioeconomic position.

• Several tools are available for gender analysis, assessment and planning or programming, which can help to identify gender inequalities in health and tailor the design, implementa-
tion and monitoring of health policies and programmes to take account of these differences, for improved outcomes. These tools include the WHO gender analysis matrix (GAM) and
gender analysis questions (GAQ), the WHO gender responsive assessment scale (GRAS) and gender analysis tool (GAT), the WHO gender and health planning and programming
checklist and the WHO gender responsive log-frame.84

• The Innov8 approach85 and Human Rights and Gender Equality in Health Sector Strategies: how to assess policy coherence86 are tools that support the development of equity-
enhancing, gender-responsive and human rights-based national health policies, programmes and strategies. Additionally, using a human rights framework in health planning and
policy making can help in identifying and adequately addressing the biological and sociocultural factors that differentially influence the health of men and women.

Endnotes

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accessed 27 July 2020).
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accessed 27 July 2020).
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